Visual cues are safe and feasible to include in post stroke walking rehabilitation

This trial assessed whether it was safe to include visual cue training (VCT) in rehabilitation therapy for patients following stroke. The study concluded that VCT was feasible to use in post stroke rehabilitation and may potentially improve walking speed, balance and walking symmetry.

Following stroke, patients often need rehabilitation therapy to help them relearn motor skills, including walking. Many patients have particular trouble with turning or moving around items in their paths. 

Previous studies have found that post-stroke patients relearning motor skills might respond better to therapy combined with external cues, such as sounds. However, it is not clear whether visual cues can help in post-stroke motor rehabilitation.

The current study examined whether the use of visual cues during walking rehabilitation was safe for patients following stroke. 

34 stroke survivors were randomly assigned to one of three rehabilitation groups. In the treadmill-visual cue training (TVCT, 11 patients) group, visual cues or obstacles were projected onto a treadmill. In the overground-visual cue training (OVCT, 10 patients) group, visual cues were stuck to a walkway on the floor. In the usual care (UC, 13 patients) group, no visual cues were used. All participants had difficulty walking. Treatments went on for 8 weeks with a follow up 4 weeks following. 

Overall there were no adverse side effects of including visual cues in the therapy. Patients reported that they found them compelling. Most patients achieved improvements in symmetry, step length and gait speed. Step symmetry and the ability to have weight on one leg improved faster in the TVCT and OVCT groups, than in the UC group. Turning time improved in the OVCT and UC groups, but did not improve in the TVCT group. 66% of OVCT patients were able to move independently on non-level surfaces, compared to 46% of the TVCT group and 25% of the UC group.

This study concluded that visual cues are feasible and safe to include in walking rehabilitation for stroke victims and may offer improvement over current treatment options.

26 patients withdrew from this study beyond the 34 include in the results. However, this was due to external reasons including health problems, changes in social housing, return to work, etc. and not due to the treatment.

This study included a small number of participants. Future studies should include larger numbers of patients.

Consult your doctor on including visual cues in walking rehabilitation therapy.